| NPI | 1992055727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178003532) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106H00000X Marriage & Family Therapist | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2014-07-23 |