| NPI | 1972750453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM 0143121) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM 0114921) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2011-10-08 |