| NPI | 1972755668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 2635) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA CCGC 1024) |
| 106H00000X Marriage & Family Therapist (Licence: LA 185) | |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2008-10-14 |