| NPI | 1831454719 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401015812) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC PRC14299) | 
| 101YM0800X Counselor, Mental Health (Licence: VA 0701005447) | |
| Enumeration Date | 2012-07-07 | 
| Last Update Date | 2017-03-01 |