| NPI | 1922124825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH10352) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068-000692) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2015-01-18 |