| NPI | 1235347253 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA LMFT001070) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA AMFT000091) | 
| Enumeration Date | 2007-05-21 | 
| Last Update Date | 2009-11-16 |