| NPI | 1336529064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A10337) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 1652) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-06-08 |