| NPI | 1164512984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 992728) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS 1274) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |