| NPI | 1518090695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MA 1164) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 4436) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2007-07-08 |