| NPI | 1205951837 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH6981) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL MH6981) | 
| 101YP2500X Counselor, Professional (Licence: SC 3545) | |
| Enumeration Date | 2007-03-20 | 
| Last Update Date | 2019-06-05 |