| NPI | 1588713416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 6292) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 1132) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-09-26 |