| NPI | 1518147859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT 1594-LCPC) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60173668) |
| Enumeration Date | 2007-11-04 |
| Last Update Date | 2012-01-15 |