| NPI | 1811396872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA 60656567) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 006233) |
| 101Y00000X Counselor (Licence: OR C4225) | |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2016-08-24 |