| NPI | 1548513310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL IMH9063) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL IMH9063) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2014-11-24 |