| NPI | 1619252269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: LA 2395) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 518) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2011-10-14 |