| NPI | 1629128012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: RI MHC00708) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 9201) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2015-06-25 |