| NPI | 1134379803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39001322A) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IN 39953) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: WV 12483) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |