| NPI | 1760734115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 12418) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH 9803) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2014-05-01 |