| NPI | 1578091179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 12069A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 12069A) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2022-07-21 |