| NPI | 1639577943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180006623) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IL 180006623) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |