| NPI | 1063625531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ID LCPC 73) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-08-23 |