| NPI | 1811077472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0701002732) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701002732) |
| 103TS0200X Psychologist School (Licence: VA 0803000039) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-09 |