| NPI | 1043613334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701006215) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WV 2111) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2015-07-08 |