| NPI | 1962657668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO MFT 768) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA MFT32640) |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2008-11-21 |