| NPI | 1205930799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 003389) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 1023143) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2007-07-08 |