| NPI | 1235273962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 2501) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1119) |
| 106H00000X Marriage & Family Therapist (Licence: LA 676) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2019-03-01 |