| NPI | 1164571378 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 4359) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 104479) | 
| Enumeration Date | 2007-01-09 | 
| Last Update Date | 2024-11-14 |