| NPI | 1003353616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 9947) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 2081) |
| Enumeration Date | 2017-01-21 |
| Last Update Date | 2017-01-21 |