| NPI | 1972745800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 095817) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IA 007189) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2019-11-07 |