| NPI | 1053436618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-3722) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LMFT-4010) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2010-12-01 |