| NPI | 1396023065 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LPC 4616) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID LCPC5443) | 
| Enumeration Date | 2011-07-29 | 
| Last Update Date | 2019-02-14 |