| NPI | 1457450520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 003356) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH6825) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2016-05-18 |