| NPI | 1164638607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL mh6698) |
| Additional Taxonomies | 101YS0200X Counselor, School |
| 222Q00000X Developmental Therapist | |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2022-02-28 |