| NPI | 1053706994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WV 1284) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E2351) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-03-30 |