| NPI | 1275093205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS 3064) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-08-21 |