| NPI | 1760887665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005580) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: VA 1691-05-001) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |