| NPI | 1740642412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T1136) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2020-02-23 |