| NPI | 1023201795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ID LCPC-4619) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ID LPC 3838) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2012-08-14 |