| NPI | 1649467655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH10709) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC2372) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2012-01-30 |