| NPI | 1154515807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 0012840) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0096351) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2017-04-12 |