| NPI | 1972735678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC004470) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC13057) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2014-02-17 |