| NPI | 1639476005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: PA PC006219) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 65242) |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2024-04-11 |