| NPI | 1790833275 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 0882) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AK 255) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2015-01-20 |