| NPI | 1639190010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH e-0000882) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH s-0007781) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-08 |