| NPI | 1528517463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4270) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 007234) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2016-10-03 |