| NPI | 1386992964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 11573) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 12930) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2013-08-08 |