| NPI | 1558795567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH12374) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH9865) |
| 101YM0800X Counselor Mental Health (Licence: 299022) | |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2015-07-22 |