| NPI | 1760791289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 963-124) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 201-228) |
| 101YP2500X Counselor, Professional (Licence: WI 976-226) | |
| 101YP2500X Counselor, Professional (Licence: WI 4956-125) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17048-130) | |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2014-03-20 |