| NPI | 1164515250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MO 2000165882) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-11 |