| NPI | 1467629568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SC 5310) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SC 5310) |
| 101YP2500X Counselor Professional (Licence: SC 5310) | |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2016-07-28 |