| NPI | 1306054598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 850) |
| 101YM0800X Counselor, Mental Health (Licence: CT CCDP-D 3841) | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2012-02-01 |