| NPI | 1205121480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA 96860) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA LH60224970) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2017-01-05 |