| NPI | 1063659092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 494) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 107869) |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2009-01-13 |