| NPI | 1891124723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TN 3877) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH 10671) |
| 101YM0800X Counselor Mental Health (Licence: FL 12973) | |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2017-03-14 |