| NPI | 1538357868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701002477) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0718000143) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000654) | |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2007-10-11 |