| NPI | 1124461884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 8765) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2014-03-26 |