| NPI | 1558560045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TN 2645) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 6901) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2011-02-22 |