| NPI | 1205856416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 000073) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 5013) |
| 101YM0800X Counselor, Mental Health (Licence: OH E0003637) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |