| NPI | 1275893612 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH 60275886) | 
| 101YP2500X Counselor, Professional (Licence: AK PCO P 933) | |
| Enumeration Date | 2012-05-19 | 
| Last Update Date | 2020-09-20 |