| NPI | 1962564997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 3802) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SC 3803) |
| 101YP2500X Counselor, Professional (Licence: SC 4967) | |
| 106H00000X Marriage & Family Therapist (Licence: SC 4503) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2015-03-13 |