| NPI | 1306250014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL IMT 1886) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2017-03-20 |