| NPI | 1659458818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 233LCPC) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT 232LCSW) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |