| NPI | 1487905410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 3884) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: RI PS00667) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |