| NPI | 1396907192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC5241) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP3645) |
| 101YP2500X Counselor, Professional (Licence: MD LC5241) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2018-07-14 |