| NPI | 1174694350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ME LC3399) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NH NH198) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2007-07-08 |