| NPI | 1043569874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 080528) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2012024652) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2016-05-25 |