| NPI | 1639247059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 574) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 3116) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2013-01-12 |