NPI | 1538246962 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC # 413) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA LMFT # 199) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2007-07-08 |