| NPI | 1528367216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701004935) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: VA 0701004935) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2016-06-21 |