| 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 |