| NPI | 1376536102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH 6477) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT 1867) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2007-07-08 |