| NPI | 1407905052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180005831) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL PMH1535) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2018-10-02 |