| NPI | 1164883039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 102885) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 90222) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2017-12-05 |