| NPI | 1023279874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL 1-01-0537) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 50706) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2018-06-20 |