| NPI | 1104325570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14512) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.005416) |
| 101YM0800X Counselor, Mental Health (Licence: IL 272.00104) | |
| 101YM0800X Counselor, Mental Health (Licence: IL 217.000115) | |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-02-12 |