| NPI | 1548537996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 002593) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 11YM0800X) |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2014-10-02 |