| NPI | 1851717128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 639) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 552) |
| 106H00000X Marriage & Family Therapist (Licence: NC 593) | |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2014-03-11 |