| NPI | 1205375508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS 170) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KS 272) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |