| NPI | 1134219678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NH 239) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VT 181) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |