| NPI | 1669723326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MS C8117) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 991428) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2015-06-09 |