| NPI | 1558578922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180-005053) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 3356-125) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |