| NPI | 1962569418 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401012205)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C500060)  | 
| 101YM0800X Counselor, Mental Health (Licence: FL 10217)  | |
| Enumeration Date | 2007-01-03 | 
| Last Update Date | 2014-06-03 |