| NPI | 1184957334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 1258-124) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 11480-132) |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2019-10-24 |