| NPI | 1063760510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 8125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 8125) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2018-03-17 |