| NPI | 1962614941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO 1651) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 1651) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2007-07-08 |