| NPI | 1760738116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA 012270) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 004178) |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF#66375) | |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2020-08-10 |