| NPI | 1811267735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: VA 0717000855) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LC1682) |
| 101YP2500X Counselor Professional (Licence: VA 0701002633) | |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2012-01-10 |