| NPI | 1265864938 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12465)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AL 1957)  | 
| Enumeration Date | 2013-08-05 | 
| Last Update Date | 2015-11-30 |