NPI | 1669715173 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166001087) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 321-228) |
101YM0800X Counselor, Mental Health (Licence: WI 16793-130) | |
Enumeration Date | 2013-04-03 |
Last Update Date | 2016-10-28 |