| NPI | 1457392003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 2414) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SC LPC #2414) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-10-13 |