| NPI | 1962174383 |
|---|---|
| Former Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 2504) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 12320A) |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2023-03-31 |