| NPI | 1063764710 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4341) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60312894) | 
| Enumeration Date | 2012-10-04 | 
| Last Update Date | 2023-07-10 |