| NPI | 1821125022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701002595) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000577) |
| 225400000X Rehabilitation Practitioner (Licence: VA 0715004083) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2007-07-08 |