| NPI | 1508020553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS 449) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WY 101) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 648) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2014-12-23 |