| NPI | 1023384328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CT 002172) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CT 002172) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2016-03-30 |