| NPI | 1124310461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO CSW-1607) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6801060455) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |