| NPI | 1609049717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00043) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IA 00108) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-04-09 |