| NPI | 1649642380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IA 078883) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: IA 078883) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2016-08-02 |