| NPI | 1659816288 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MFT001585)  | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT3245)  | 
| Enumeration Date | 2017-01-05 | 
| Last Update Date | 2018-07-02 |