| NPI | 1063534220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MA 5476) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 5476) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2015-03-03 |