| NPI | 1477785905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MT 1315-LCPC) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT 1315-LCPC) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2012-03-01 |