| NPI | 1104959303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM 0099491) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM 0099491) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2014-03-14 |