| NPI | 1407058639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 1189) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 1) |
| 106H00000X Marriage & Family Therapist (Licence: OK 244) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2010-03-22 |