| NPI | 1649647280 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401015308) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A9940) | 
| Enumeration Date | 2015-08-31 | 
| Last Update Date | 2016-11-29 |