| NPI | 1114332558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 001327) |
| 251S00000X (Licence: WA CG60372901) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |