| NPI | 1467513556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 4776) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 1207) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2007-07-08 |