| NPI | 1255423414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 822) |
| Additional Taxonomies | 251S00000X (Licence: MA 822) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2008-11-12 |