| NPI | 1376528174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPCMH 2066) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SD LMFT1063) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2024-01-25 |