| NPI | 1104951060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 3816) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA 2962) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2016-01-08 |