| NPI | 1912210873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 000008947) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ME CC4051) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2015-04-02 |