| NPI | 1336409259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO 14094) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IA 073831) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2015-05-13 |