| NPI | 1073524054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 5907) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MA 5907) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2011-12-20 |