| 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 (Licence: IL 149.011496) |
| 251S00000X (Licence: IL 149.011496) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-11 |