| NPI | 1114239159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 5707125) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 5707125) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2015-06-30 |