| NPI | 1790824811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NH 620) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 5671) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2018-06-19 |