| NPI | 1548240401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD LPC-MH2026) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SD LMFT1055) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2012-03-23 |