| NPI | 1457596553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 528) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SC 1505) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2015-03-13 |