| NPI | 1528105913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KS LPC 1049) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS LPC 1049) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-10-13 |