| NPI | 1760990923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.011411) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166.001171) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-01-22 |