| NPI | 1972604395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00712) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IA 00202) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |