| NPI | 1336342609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2011010451) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH4800) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH 9432) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2011-06-24 |