| NPI | 1225568140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA CG60928310) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 94939) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2019-01-07 |