| NPI | 1306270756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5207-125) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 364-228) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2019-12-03 |