| NPI | 1235770538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 705-228) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4359-226) |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2019-10-08 |