| NPI | 1801157144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 12917) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 66413) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2017-04-12 |