| NPI | 1982757647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS 3611) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 3611) |
| 1041C0700X Social Worker, Clinical (Licence: KS 3611) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-08 |