| NPI | 1750617049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-12379) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C2986) |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2016-05-04 |