| NPI | 1700979820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 72000) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180005166) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2014-02-12 |