| NPI | 1215060538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-120) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C1279) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2008-07-11 |