| NPI | 1235560798 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4284)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R3104)  | 
| Enumeration Date | 2013-12-10 | 
| Last Update Date | 2020-07-15 |