| NPI | 1912316167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NJ 37PC00282000) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: PA PC005310) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2014-08-12 |