| NPI | 1790989655 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH3418) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT1773) | 
| Enumeration Date | 2007-06-13 | 
| Last Update Date | 2011-09-16 |