| NPI | 1679769301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT 44032) |
| Additional Taxonomies | 225700000X Massage Therapist |
| 235Z00000X Speech-Language Pathologist, (Licence: MT 1035) | |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2022-05-03 |