| NPI | 1912965005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KS 905) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IA 132) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2007-07-08 |