| NPI | 1366634115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH 9070) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL MH9070) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2012-04-30 |