| NPI | 1184848939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5162-125) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN 3698) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2014-03-12 |