| NPI | 1629310990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR T1001) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 51797) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2016-02-23 |