| NPI | 1821208364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO 4064) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 8029) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-06-28 |