| NPI | 1962080317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AL L560) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT3968) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-03-29 |