| NPI | 1760518880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS 1013) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OK 385) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 228) | |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2013-01-23 |