| NPI | 1619068905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701002425) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0710000995) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000590) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-04-02 |