| NPI | 1922454248 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 104100000X Social Worker | 
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2016-05-05 | 
| Last Update Date | 2016-07-12 |