| NPI | 1790866556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 51498) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000005) |
| 101YP2500X Counselor, Professional (Licence: VA 0701002169) | |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000078) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |