| NPI | 1740328772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 549) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 1430) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |