NPI | 1508136987 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH 9080) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL IMT1568) |
Enumeration Date | 2012-01-03 |
Last Update Date | 2012-01-03 |