| NPI | 1215912233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC LPC448) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC LISWCP66) |
| 106H00000X Marriage & Family Therapist (Licence: SC LMFT1585) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2007-07-08 |