| NPI | 1740532183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 300-228) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16723-130) |
| 101YP2500X Counselor, Professional (Licence: WI 1553-226) | |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2014-06-11 |