| NPI | 1033413034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 0162) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OK 0162) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-01-05 |