| NPI | 1972704625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT 1481 - LCPC) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LPC3753) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2012-04-10 |