| NPI | 1356742324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC5718) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 5248852-6004) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2015-03-02 |