| NPI | 1043560956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 103T00000X Psychologist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2018-04-02 |