| NPI | 1619039617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 4296) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SC 4259) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2010-06-16 |