| NPI | 1225584139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0701006633) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: UT 7133302-6004) |
| 101YM0800X Counselor Mental Health (Licence: NY 004415) | |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2017-03-23 |