NPI | 1285818161 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: UT 5534230-6004) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701001915) |
106H00000X Marriage & Family Therapist (Licence: VA 0717000682) | |
Enumeration Date | 2007-12-27 |
Last Update Date | 2007-12-27 |