| NPI | 1104986579 |
|---|---|
| Former Name | NONE NONE NONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LPC333) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA CRC50029) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2013-04-05 |