| NPI | 1962753897 |
|---|---|
| Former Name | SARAH RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: ME XM4190) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 106H00000X Marriage & Family Therapist (Licence: NH 182) | |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2015-09-21 |