| NPI | 1184818940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 63102) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IL 00048057) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2012-11-10 |