| NPI | 1811429491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: PA PC007803) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 1473) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2017-04-01 |