| NPI | 1134271844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 676) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 2083) |
| 101YP2500X Counselor Professional (Licence: NE 1194) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2011-06-16 |