| NPI | 1932445723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 1829) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 4725) |
| 101YP2500X Counselor Professional (Licence: NE 2279) | |
| Enumeration Date | 2012-12-24 |
| Last Update Date | 2019-04-11 |