| NPI | 1811269376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401013339) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6401013339) |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2013-12-03 |