| NPI | 1760752018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11310) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL RMHI8269) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2013-01-23 |