| NPI | 1407269665 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 12592)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 65266)  | 
| Enumeration Date | 2014-06-05 | 
| Last Update Date | 2014-06-05 |