NPI | 1255497491 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180-003343) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166-000275) |
Enumeration Date | 2006-12-30 |
Last Update Date | 2007-07-08 |