| NPI | 1376696880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MA 6972) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106H00000X Marriage & Family Therapist (Licence: MA 1353) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2011-04-19 |