| NPI | 1811050685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 1505) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NE 1505) |
| 1041C0700X Social Worker Clinical (Licence: NE 1505) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2015-01-22 |