NPI | 1306103320 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701001735) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000384) |
Enumeration Date | 2012-04-15 |
Last Update Date | 2012-04-15 |