| NPI | 1629063292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701001746) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0812000813) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000828) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2007-07-08 |