| NPI | 1104192079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MHC16931) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH 9780) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2020-01-22 |