| NPI | 1578804423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 1921) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MA 1921) |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2013-03-01 |