| NPI | 1649593526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH8282) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA MFC40055) |
| 101YM0800X Counselor Mental Health (Licence: FL MT2261) | |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2010-12-03 |