| NPI | 1326369448 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 2511) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 510) | 
| Enumeration Date | 2010-06-14 | 
| Last Update Date | 2010-06-14 |