| NPI | 1568739688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 636) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WY 054) |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2011-11-17 |