| NPI | 1063743524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 7636) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 1700) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2017-01-26 |