| NPI | 1104895457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA pc000441) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ pc00302500) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2007-07-08 |