| NPI | 1194732537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701001259) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH2113) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000283) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |