| NPI | 1548456445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AL 2814) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MS LPC 1171) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2012-08-20 |