| NPI | 1972078780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 10387) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 1695) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |