| NPI | 1952839862 | 
|---|---|
| Professional Name | N/A N/A | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60801971)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180010852)  | 
| 101YP2500X Counselor, Professional (Licence: IL 180010852)  | |
| Enumeration Date | 2017-05-23 | 
| Last Update Date | 2018-10-30 |