| NPI | 1619140621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: UT 5723021-6009) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 43983) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |