| NPI | 1912033770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 450) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 189) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2007-07-08 |