| NPI | 1508138462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 60593818) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0176401) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2016-01-04 |