| NPI | 1710198254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701003520) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717001065) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2007-07-08 |