| NPI | 1144423906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 180-002881) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 3887-125) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2012-05-03 |