| NPI | 1609278258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YS0200X Counselor School (Licence: FL 10961) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IMH10961) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2019-10-15 |