| NPI | 1578878633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: OK 10042011) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 00013) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2011-12-12 |