| NPI | 1124362595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA 007768) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC004110) |
| Enumeration Date | 2012-11-24 |
| Last Update Date | 2018-11-06 |