| NPI | 1194901819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MA 766) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 6304) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2008-01-11 |