| NPI | 1063796092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 103523) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CO 933352) |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2014-10-06 |