| NPI | 1790788206 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 3425 LPC)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 47974 NCC)  | 
| Enumeration Date | 2005-05-30 | 
| Last Update Date | 2007-10-30 |