| NPI | 1699021774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: LA 2559) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LA 2559) |
| 101YP2500X Counselor Professional (Licence: LA 2559) | |
| 106H00000X Marriage & Family Therapist (Licence: LA MFT 952) | |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2012-07-26 |