| NPI | 1275683674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 10913) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA LPC735) |
| 106H00000X Marriage & Family Therapist (Licence: MO 2010037686) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2019-09-20 |