| NPI | 1508095506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC 0011193) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1337) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2019-11-04 |