| NPI | 1174712566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TN 2206) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KY 0962) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2016-10-25 |