| NPI | 1508100066 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: SC 6940) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 6940) | 
| Enumeration Date | 2012-11-21 | 
| Last Update Date | 2012-11-21 |