| NPI | 1003820713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH5779) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 20247) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2007-07-08 |