| NPI | 1396841359 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0002530) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KS 286) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2024-04-05 |