| NPI | 1730642653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH15012) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT3604) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2022-07-28 |