| NPI | 1457760886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT BBH-LMFT-LIC-53058) |
| 106H00000X Marriage & Family Therapist (Licence: CA 123236) | |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2022-10-11 |