| NPI | 1083883292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001183) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.007054) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2009-03-09 |