| NPI | 1811103401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC1135) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC PRC704) |
| 101YM0800X Counselor, Mental Health (Licence: VA 0701002312) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |