| NPI | 1629305396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2009026111) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 2012006797) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2012-05-31 |