| NPI | 1437270832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TN 563) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MS 563) |
| 103T00000X Psychologist (Licence: TN 563) | |
| 103T00000X Psychologist (Licence: MS 563) | |
| 106H00000X Marriage & Family Therapist (Licence: TN 563) | |
| 106H00000X Marriage & Family Therapist (Licence: MS 563) | |
| 106H00000X Marriage & Family Therapist (Licence: TN 202) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2007-07-08 |