| NPI | 1659703551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 1321-124) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 081638) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2020-10-24 |