| NPI | 1144530957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC4524) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 7844) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2012-08-20 |