| NPI | 1265712327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH10631) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL 10631) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2012-05-16 |