| NPI | 1053435149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MT 1033) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MT 1033) |
| 101YP2500X Counselor Professional (Licence: MT 1033) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2015-10-14 |