| NPI | 1679644165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SD LPC-MH 2057) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SD LMFT 1065) |
| 101YM0800X Counselor Mental Health (Licence: SD LPC-MH 2057) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2024-03-20 |