| NPI | 1073774212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 14804) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 4104) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2019-07-11 |