| NPI | 1821364860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MT 2174 LCPC) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MT 2174 LCPC) |
| 101YM0800X Counselor Mental Health (Licence: MT 2174 LCPC) | |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2015-09-04 |