| NPI | 1255595112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401009631) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2020-09-03 |