| NPI | 1689210239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2019040727) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 2019040727) |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2019-11-19 |