| NPI | 1639761943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: SC 4575) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SC 5572) |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-02-10 |