| NPI | 1316312507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 6430) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA 6430) |
| 106H00000X Marriage & Family Therapist (Licence: LA 1276) | |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2021-08-27 |