| NPI | 1114944162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 379) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 232) |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: MA 105760) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2015-12-21 |