| NPI | 1376694463 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: VA 071700118) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701004004) | 
| Enumeration Date | 2007-01-15 | 
| Last Update Date | 2024-07-12 |