| NPI | 1134445570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 12629) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2021-11-01 |