| NPI | 1568443067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 001497) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180001503) |
| 106H00000X Marriage & Family Therapist (Licence: MO 300096) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2007-07-08 |