| NPI | 1922372069 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 3661) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4889) | 
| 106H00000X Marriage & Family Therapist (Licence: WI 1160) | |
| Enumeration Date | 2012-03-07 | 
| Last Update Date | 2019-07-20 |