| NPI | 1891005302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MO 2012022112) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KS 1031) |
| 106H00000X Marriage & Family Therapist (Licence: KS 800) | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2015-09-30 |