| NPI | 1912030636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AL 534) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: 4141) |
| 106H00000X Marriage & Family Therapist (Licence: AL 149) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |