| NPI | 1154684603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OK 5276) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OK 5276) |
| 101YP2500X Counselor Professional (Licence: OK 5276) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2014-10-22 |