| NPI | 1336442318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC0940) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701004670) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2013-02-20 |