| NPI | 1184630196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0015471) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KS 1980) |
| 101YM0800X Counselor Mental Health (Licence: WA RC00055242) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2019-07-02 |