| NPI | 1578664090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701002573) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000669) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2012-09-12 |