| NPI | 1104907971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 9069) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068-0000096) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2014-11-09 |