| NPI | 1982978565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12109) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH9369) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2014-01-06 |