| NPI | 1225175243 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE LMHP 3080) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE LPC 1600) | 
| 101YM0800X Counselor, Mental Health (Licence: NE 3080) | |
| Enumeration Date | 2007-01-31 | 
| Last Update Date | 2009-04-15 |