| NPI | 1679979702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC A10846) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A10846) |
| 101YP2500X Counselor, Professional (Licence: NC A10846) | |
| 251S00000X Community/Behavioral Health (Licence: NC A10846) | |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |