| NPI | 1750775243 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL mh13386) | 
| 251S00000X Community/Behavioral Health (Licence: FL mh13386) | |
| Enumeration Date | 2015-03-24 | 
| Last Update Date | 2017-06-06 |