| NPI | 1659356459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC699) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SD LMFT1164QMHP) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2007-07-08 |