| NPI | 1982341640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 2011-124) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2022-05-15 |
| Last Update Date | 2025-08-13 |