| NPI | 1316467707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 4677-125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 4677-125) |
| 106H00000X Marriage & Family Therapist (Licence: WI 4677-125) | |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2017-06-26 |