| NPI | 1235424664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 1202) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 3895) |
| 101YP2500X Counselor Professional (Licence: NE 1929) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2014-11-24 |