| NPI | 1316285364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SD LPC 1197) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SD QMHP) |
| Enumeration Date | 2013-01-26 |
| Last Update Date | 2013-01-26 |