| NPI | 1336482066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180009858) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IL 178.008892) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2015-08-19 |