| NPI | 1053672899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6401002401) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401002401) |
| 101YP2500X Counselor Professional (Licence: MI 6401002401) | |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2012-06-07 |