| NPI | 1487843058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC-5293) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 00494) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2009-11-13 |