| NPI | 1629115746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-4300) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC35471) |
| 106H00000X Marriage & Family Therapist (Licence: ID LMFT-4199) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2009-02-17 |