| NPI | 1902952716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 2134) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 431) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-07-08 |