| NPI | 1447546908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 8560) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: NC A8560) |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: NC 8560) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2018-03-08 |