NPI | 1639386253 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: AL 1370) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 667) |
Enumeration Date | 2007-05-16 |
Last Update Date | 2007-07-08 |