| NPI | 1659781011 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00511700) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 37AC00099600) | 
| 101YM0800X Counselor, Mental Health (Licence: NJ 37AC00099600) | |
| Enumeration Date | 2014-05-06 | 
| Last Update Date | 2015-01-05 |