| NPI | 1043403058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NM LPCC0770) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NM LMSWM1665) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-22 |