| NPI | 1194007146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA 001464) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SC 4585) |
| 106H00000X Marriage & Family Therapist (Licence: FL IMT 2855) | |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2016-09-01 |