| NPI | 1336226513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2003031287) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 300019) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2009-07-16 |