| NPI | 1023385655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AL 1384) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: AL 1384) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2022-08-03 |