| NPI | 1063612216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 2809) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CT 2809) |
| 101YM0800X Counselor Mental Health (Licence: CT 2809) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2015-08-19 |