| NPI | 1164582185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NM 0091341) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0171441) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2015-03-18 |