| NPI | 1649370545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ME CC 3422) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 169) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2010-10-07 |