| NPI | 1306145503 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11849) | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2011-03-28 | 
| Last Update Date | 2019-12-06 |