| NPI | 1578749578 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 4838)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 4838)  | 
| Enumeration Date | 2008-01-21 | 
| Last Update Date | 2016-05-16 |