| NPI | 1205394210 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180012432) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.013015) | 
| 101YP2500X Counselor, Professional (Licence: IL 178.013015) | |
| Enumeration Date | 2019-03-08 | 
| Last Update Date | 2019-08-20 |