| NPI | 1174515308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE CPC 447) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE LMHP 456) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2007-07-08 |