| NPI | 1053533992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 2304) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 3102) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2008-07-28 |