| NPI | 1174096648 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DC LGPC00394) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP8846) | 
| Enumeration Date | 2019-01-08 | 
| Last Update Date | 2019-01-08 |