| NPI | 1487819868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 634124) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 201729) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2011-09-11 |