| NPI | 1134393440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 11176) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701009164) |
| 101YP2500X Counselor, Professional (Licence: NC A11176) | |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2023-09-05 |