| NPI | 1497053144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WY 1381) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 405) |
| 102L00000X Psychoanalyst (Licence: NE 1799) | |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2018-01-26 |