| NPI | 1770721862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 001669) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701001554) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000462) | |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2019-09-06 |