| NPI | 1992912703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 1130-228) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2025-01-13 |