| NPI | 1104988005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL LMI24) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: FL SS251) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2007-08-08 |