| NPI | 1679659825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD QMHP) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SD LPC-MH 2131) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2007-07-08 |