| NPI | 1235473125 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005415)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00330200)  | 
| Enumeration Date | 2012-11-16 | 
| Last Update Date | 2013-03-07 |