| NPI | 1043446594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0701004573) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WV 929) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2009-06-10 |