| NPI | 1083967145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH15316) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0701006395) |
| 101Y00000X Counselor (Licence: MD LC4739) | |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2017-10-31 |