| NPI | 1508058868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: VA 0717001203) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 757124) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2009-12-16 |