| NPI | 1174738074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY 885) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 001692) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2019-12-16 |