| NPI | 1265948194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MO 7780) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 9827) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2018-06-16 |