| NPI | 1255759445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 3958) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AL 3958) |
| 101YM0800X Counselor, Mental Health (Licence: IL 180.008965) | |
| 101YP2500X Counselor, Professional (Licence: IL 180.008965) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2019-07-09 |