| NPI | 1205119930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401013086) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2018-04-30 |