| NPI | 1285642520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LCPC 137) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA LH00003616) |
| 106H00000X Marriage & Family Therapist (Licence: ID LMFT 3069) | |
| 106H00000X Marriage & Family Therapist (Licence: WA LF00000961) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-07-08 |