| NPI | 1780999102 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 4137) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 2032) | 
| Enumeration Date | 2010-08-10 | 
| Last Update Date | 2012-10-25 |