| NPI | 1376956086 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T2487) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 106196) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2024-08-27 |