| NPI | 1730579285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 11747) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 9131) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-09-14 |