| NPI | 1174849475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 1583-LCPC) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1341) |
| 106H00000X Marriage & Family Therapist (Licence: MT 139) | |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2012-08-20 |