| NPI | 1275504680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 2386) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 162) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2007-07-08 |