| NPI | 1235584764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MD LCM528) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC LMFT 1694) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-12-06 |