| NPI | 1235643727 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH13529) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00534700) | 
| Enumeration Date | 2017-11-21 | 
| Last Update Date | 2017-11-21 |