| NPI | 1043512379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC 5380) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM LPCC 0118911) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2010-11-18 |