| NPI | 1043765308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL 17651) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2020-03-03 |