| NPI | 1710178009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 1115) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 977) |
| 106H00000X Marriage & Family Therapist (Licence: FL 973) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2022-04-04 |