| NPI | 1174802318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ND 692-7-15-11-242) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 1076) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2015-10-20 |