| NPI | 1528179918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 695) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 1819) |
| 101YP2500X Counselor Professional (Licence: NE 1085) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-05-16 |