| NPI | 1548524846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 9117) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NH 1052) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2017-10-13 |