| NPI | 1790819027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SD LPC949) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2014-06-20 |