| NPI | 1992998900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 903) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 10097) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15750) | |
| 106H00000X Marriage & Family Therapist (Licence: IA 000347) | |
| 106H00000X Marriage & Family Therapist (Licence: IL 166000869) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2014-12-18 |