| NPI | 1013395722 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 6104) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 101YP2500X Counselor, Professional (Licence: NC A11336) | |
| Enumeration Date | 2015-05-13 | 
| Last Update Date | 2018-04-26 |