| NPI | 1508301458 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA CSW003751) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA CSW003751) | 
| Enumeration Date | 2017-01-02 | 
| Last Update Date | 2017-01-02 |