| NPI | 1700138120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001538) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178007708) |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2013-02-11 |