| NPI | 1881976678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 2057) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 4200) |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2015-02-27 |