| NPI | 1306219316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 6425) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SC 6425) |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2016-10-11 |