| NPI | 1801109426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MA LMHC 4070) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA LADC1 1017) |
| Enumeration Date | 2010-07-24 |
| Last Update Date | 2010-07-24 |