| NPI | 1639462658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5212) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 7735) |
| 106H00000X Marriage & Family Therapist (Licence: NC 1321) | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2011-05-24 |