| NPI | 1487791604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH02676) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL SS00305) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |