| NPI | 1104269778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 3706) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 1363) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2013-04-18 |