NPI | 1710395629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH30504) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SD LMFT1231) |
Enumeration Date | 2014-07-24 |
Last Update Date | 2022-12-14 |