| NPI | 1053524801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2789) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 00943) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |