| NPI | 1619032018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 419) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IA 1494) |
| 106H00000X Marriage & Family Therapist (Licence: IA 127) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2007-07-08 |