| NPI | 1407855570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL 2049) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 2187) |
| 101YM0800X Counselor, Mental Health (Licence: FL 5993) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2014-01-27 |