| NPI | 1912267444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401013249) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6401013249) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2018-10-23 |