| NPI | 1568852051 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 5016)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10479)  | 
| Enumeration Date | 2015-02-04 | 
| Last Update Date | 2018-03-17 |