| NPI | 1124399175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS 2490) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2012002892) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-03-28 |