| 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 | 2009-11-19 |