| NPI | 1013453596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC P011181) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC P011181) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2018-01-10 |