| NPI | 1134561954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 23914) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL 1134561954) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2025-04-15 |