| NPI | 1043493174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.007992) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: IL 180.007992) |
| 101YM0800X Counselor, Mental Health (Licence: IL 180.007992) | |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2013-05-08 |