| NPI | 1922434646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 6805030174) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-003866) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2013-11-20 |