| NPI | 1154682318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00434) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 01148) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2012-06-05 |