| NPI | 1114289576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 9574) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 9574) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2016-10-13 |