| NPI | 1386061109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC PC11066) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 10744) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2019-03-25 |