| NPI | 1629205653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TN 2772) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 5360) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2013-12-12 |