| NPI | 1790223162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MT BBH-LCPC-LIC-29694) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ND 2015-051) |
| 106H00000X Marriage & Family Therapist (Licence: MN 3473) | |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2023-05-10 |