| NPI | 1912064387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC0004) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MD LC0004) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |