| NPI | 1619996519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 2492) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 2492) |
| 101YS0200X Counselor, School (Licence: LA 74931) | |
| 106H00000X Marriage & Family Therapist (Licence: LA 72) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-08 |