| NPI | 1922517739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH21024) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL IMT3214) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2022-08-02 |