| NPI | 1790075521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME CC3949) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: UT 7156525) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2012-05-10 |