| NPI | 1245624725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SC 6106) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: SC 6106) |
| 101Y00000X Counselor (Licence: SC 6016) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2016-01-05 |