| NPI | 1396865846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 5095) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 7111) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2013-01-12 |