| 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 |