| NPI | 1205093994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 841-124) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 15-228) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2010-07-07 |