| NPI | 1841540515 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: LA 2797) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 884) | 
| Enumeration Date | 2012-09-10 | 
| Last Update Date | 2012-09-10 |