| NPI | 1760752638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 9215) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A9215) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2017-04-05 |