| NPI | 1588927743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 6527) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OK 6527) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2018-11-20 |