| NPI | 1053657163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0011666) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 4837) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2019-04-04 |