NPI | 1881059616 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16634) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH 14153) |
106H00000X Marriage & Family Therapist (Licence: FL IMT 2417) | |
Enumeration Date | 2015-12-21 |
Last Update Date | 2019-02-19 |