| NPI | 1245745066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 6509) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SC 4660) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2017-12-04 |