| NPI | 1205217544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY 087867) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NJ 44SL05796600) |
| 106H00000X Marriage & Family Therapist (Licence: PA SW129813) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-06-12 |