| NPI | 1225201189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM 0092291) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH 6773) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |