| NPI | 1184872251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0012630) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178005203) |
| 101YP2500X Counselor, Professional (Licence: IL 180.007439) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2016-04-12 |