| NPI | 1861790768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC2826) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MD LCM363) |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2011-03-02 |