| NPI | 1629340617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.009186) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 208.000247) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2014-12-06 |