| NPI | 1356532394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH9105) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301009907) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2013-09-25 |