| NPI | 1285968842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC-5601) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2016-08-17 |