| NPI | 1629369822 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2011-04-22 | 
| Last Update Date | 2013-07-08 |