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 |