| NPI | 1053643247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2010041800) |
| 101YP2500X Counselor, Professional (Licence: GA LPC011006) | |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2021-09-24 |