| NPI | 1336581404 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR c3168) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR C3168) | 
| 101YM0800X Counselor, Mental Health (Licence: OR c3168) | |
| Enumeration Date | 2013-07-18 | 
| Last Update Date | 2019-04-24 |