| NPI | 1407868185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0904005571) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TN 4450) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2009-09-23 |