| NPI | 1790205102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 18412) |
| 106H00000X Marriage & Family Therapist (Licence: FL 3954) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-01-04 |