| NPI | 1104292127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 261QA0600X) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401013637) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2015-08-13 |