| NPI | 1083972632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS LCPC03524) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional (Licence: OR C2902) | |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2023-09-05 |