| NPI | 1992163430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IA 082624) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2018-12-03 |