| NPI | 1104912930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM 0122691) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0099771) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2009-05-15 |