| NPI | 1801959754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MA 3014) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 3014) |
| 101YP2500X Counselor, Professional (Licence: MA 3014) | |
| 106H00000X Marriage & Family Therapist (Licence: MA 3014) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-07-08 |