| NPI | 1972808418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 000737) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA 001119) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |