| NPI | 1760859052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T1770) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2021-10-06 |