| NPI | 1124212394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK 4875) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 0103541) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2014-01-17 |