| NPI | 1538439674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AL 748) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AL 179) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |