| NPI | 1295442283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2023-10-27 |