| NPI | 1639255714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE LMHP 455) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NE CPC 495) |
| 106H00000X Marriage & Family Therapist (Licence: NE CMFT 009) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2007-07-08 |