| 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 |