| NPI | 1942345558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ID LCPC2918) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ID 2918) |
| 106H00000X Marriage & Family Therapist (Licence: ID 3016) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2019-01-30 |