| NPI | 1609909811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC75) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID LMFT2739) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2007-07-08 |