| NPI | 1336283480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MA 119037) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TN LSW0000003086) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2019-07-26 |