| NPI | 1790191112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 0800) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MS T0297) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-07 |