| NPI | 1750663241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IA 086495) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: HI 175) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717001225) | |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2018-09-26 |