| NPI | 1528146057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: GA 001258) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA 000785) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |