| NPI | 1104030337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: HI 588) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 4558) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2019-12-17 |