| NPI | 1285022905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-42636) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 441-228) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2020-08-25 |