| NPI | 1306891437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC LPC #374) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC LPC #374) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2019-07-08 |