| NPI | 1134637291 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 221700000X Art Therapist (Licence: NM 2432) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH8617) | 
| Enumeration Date | 2018-01-10 | 
| Last Update Date | 2018-01-10 |