| NPI | 1023489887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MO 2016011192) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KS 2797) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2018-04-27 |