| NPI | 1790951473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH00008190) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 11353) |
| 101YP2500X Counselor, Professional (Licence: AL 3083) | |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2014-08-20 |