| NPI | 1720195670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD 11759) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC LC301809) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-07-09 |