| NPI | 1083928493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 5062-125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 4202) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2013-04-19 |