| NPI | 1902177355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH8069) |
| Additional Taxonomies | 251S00000X (Licence: FL IMH8069) |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2014-06-19 |