| NPI | 1801959366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 34003424A) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: IN 34003424A) |
| 106H00000X Marriage & Family Therapist (Licence: IN 34003424A) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-07-08 |