| NPI | 1073717708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 3266) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 00936) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2009-03-27 |