| NPI | 1609082254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: SC 4518) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SC 1102249) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2019-07-01 |