| NPI | 1912103821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 7829) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 7829) |
| 101YP2500X Counselor Professional (Licence: NC 7829) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2014-06-23 |