| NPI | 1104969864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701004937) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC2778) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2011-08-05 |