| NPI | 1841576758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH2215) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SD LPC7068) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2011-10-25 |