| NPI | 1396883179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 2474125) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 184124) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |