| NPI | 1245502574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T0572) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 07-R-10) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 0726) | |
| 106H00000X Marriage & Family Therapist (Licence: NV 0852) | |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |