| NPI | 1063648335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2007010646) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2007010646) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2014-04-17 |