| NPI | 1902950801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 005466) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 004020) | 
| Enumeration Date | 2007-01-22 | 
| Last Update Date | 2010-01-04 |