| NPI | 1124142914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 1017179) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 1017179) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |