| NPI | 1912291865 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH00005031) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LPC784) | 
| Enumeration Date | 2011-06-07 | 
| Last Update Date | 2011-06-07 |