| NPI | 1154782860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0015388) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 75287) |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2019-05-06 |