| NPI | 1407105976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: LA 4164) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: LA 4164) |
| 101Y00000X Counselor (Licence: LA 4164) | |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2021-06-09 |