| NPI | 1679630347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MT 471LCPC) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT 731) |
| 106H00000X Marriage & Family Therapist (Licence: MT LMFT2230) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2012-04-03 |