| NPI | 1639430408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 9452) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC 9452) |
| 101Y00000X Counselor (Licence: NC 9452) | |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2015-02-02 |