| NPI | 1205375177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SD LPC7426) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SD LMFT1229) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |