| NPI | 1598268344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 6403) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA 6403) |
| 101YM0800X Counselor, Mental Health (Licence: LA 6403) | |
| 106H00000X Marriage & Family Therapist (Licence: LA 1254) | |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2018-03-16 |