NPI | 1760694616 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 3290) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA MFT1043) |
Enumeration Date | 2007-05-04 |
Last Update Date | 2007-07-08 |