NPI | 1235293242 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SD LMFT) |
Enumeration Date | 2006-12-21 |
Last Update Date | 2011-05-05 |