| 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 |