| NPI | 1841383320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT1700) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH3269) |
| 101YP2500X Counselor, Professional (Licence: CO LPC3024) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2008-11-13 |