| NPI | 1619414729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA 1007) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: CA 2894) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |