| NPI | 1568612554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 7110) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NC 7110) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2021-10-07 |