| NPI | 1023176039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0002809) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 2809) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2019-06-18 |