| NPI | 1689921041 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11372) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH8456) | 
| Enumeration Date | 2012-08-04 | 
| Last Update Date | 2018-06-01 |