| NPI | 1609380567 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 7045) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 7045) | 
| 101YM0800X Counselor, Mental Health (Licence: SC 6522) | |
| 101YP2500X Counselor, Professional (Licence: SC 6522) | |
| Enumeration Date | 2017-11-29 | 
| Last Update Date | 2019-02-03 |