| NPI | 1104965649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC5836) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 10772) |
| 101YM0800X Counselor, Mental Health (Licence: NC 4998) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-07-16 |