| NPI | 1083715874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: LA 3522) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 3522) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |