| NPI | 1114038809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 391) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 1012) |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: NE 30084) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-12-05 |