| NPI | 1376897074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 1800008190) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180008190) |
| 101YM0800X Counselor, Mental Health (Licence: IL 180008190) | |
| 101YP2500X Counselor, Professional (Licence: IL 180008190) | |
| 251S00000X (Licence: IL 180008190) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 180008190) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 180008190) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IL 180008190) | |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2019-05-08 |