| NPI | 1619020690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 3241) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 426) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2008-04-29 |