| NPI | 1972538577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA 3279) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA 3279) |
| 101YP2500X Counselor Professional (Licence: GA 3279) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2007-07-08 |