| NPI | 1093069049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 005444) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS 1763) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |