| NPI | 1003038514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AL 2489) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 2006016237) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |