| NPI | 1558606301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: LA 2684) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 666) |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-05 |