| NPI | 1962688481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS LCPC2302) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH9603) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2013-05-02 |