| NPI | 1972612620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: LA 2297) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 17734) |
| 106H00000X Marriage & Family Therapist (Licence: LA MFT297) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |