| NPI | 1154571628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 1574) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 0828) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2014-06-16 |