| NPI | 1538219464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 001415) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 2000143809) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-07-09 |