| NPI | 1619261344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 4356) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA MFT1147) |
| Enumeration Date | 2011-05-28 |
| Last Update Date | 2013-04-04 |