| NPI | 1114176260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS LCPC188) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL PMH 1065) |
| Enumeration Date | 2008-09-13 |
| Last Update Date | 2014-04-30 |