| NPI | 1316243967 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 461)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 7548)  | 
| 101YM0800X Counselor, Mental Health (Licence: CA PCI 69)  | |
| Enumeration Date | 2011-01-30 | 
| Last Update Date | 2015-04-23 |