| NPI | 1104834696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH5302) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL MH5302) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2010-02-24 |