| NPI | 1649785544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 27109) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT 22758) |
| 106H00000X Marriage & Family Therapist (Licence: CA 93696) | |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2018-03-17 |