| NPI | 1376551416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 107920) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 00789) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2012-03-21 |