| NPI | 1922417344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS 2640) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 1348) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2015-11-17 |