| NPI | 1962411645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 000459) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 101 Y00000X) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2008-06-16 |