| NPI | 1760721252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: VA 0717001324) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 23079) | |
| 103T00000X Psychologist | |
| 106H00000X Marriage & Family Therapist (Licence: NY 000059) | |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2020-08-22 |