| NPI | 1912281445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: PA PC007579) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH10865) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2016-06-21 |