| NPI | 1912033069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MO 1374) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: KS 0734) |
| 106H00000X Marriage & Family Therapist (Licence: KS 0018) | |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2007-07-15 |