| NPI | 1770706178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 405) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 3105548) |
| 106H00000X Marriage & Family Therapist (Licence: MA 250) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |