| NPI | 1003975905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NH 847) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AK LPA #A0279) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2014-01-02 |