| NPI | 1407086192 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.007361) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178.003775) | 
| Enumeration Date | 2009-07-16 | 
| Last Update Date | 2015-11-30 |