| NPI | 1104205194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.1400233-CR) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1400233-CR) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2015-05-22 |