| NPI | 1235301540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 0011530) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WY 1078) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2015-01-03 |