| NPI | 1124174784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 6108) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: MA 3232) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |