| NPI | 1235116294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LCPC2968) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID LMFT2967) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2007-07-08 |