| NPI | 1124401294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NM X-09053) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |