| NPI | 1417011610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC S6748) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 5736) |
| 101YM0800X Counselor, Mental Health (Licence: NC 6748) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2013-07-15 |