| NPI | 1174695589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC5872) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: RI MHC00401) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2012-05-17 |