| NPI | 1619909918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701004586) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM 0099361) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2015-03-20 |