| NPI | 1265784037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: SC 6073) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SC LPCI-5514) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2016-06-15 |