| NPI | 1699163428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 180.010973) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.010973) |
| 101YM0800X Counselor, Mental Health (Licence: IL 180.010973) | |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2019-04-10 |