| NPI | 1679862015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103T00000X Psychologist | |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2011-04-06 |