| NPI | 1114135324 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.012879) | 
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: SC LPCI #4985) | 
| 101YP1600X Counselor, Pastoral (Licence: NC Associate #66) | |
| 101YP1600X Counselor, Pastoral (Licence: SC LPC 5356) | |
| 101YP2500X Counselor, Professional (Licence: SC LPC 5356) | |
| Enumeration Date | 2007-05-19 | 
| Last Update Date | 2020-10-30 |