| NPI | 1104059757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME CC117) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701000049) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2009-08-31 |