| NPI | 1083607964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 4769) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NH 609) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2011-05-11 |