| NPI | 1659617330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KY 162610) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IN 39002762A) |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2016-07-18 |