| NPI | 1194711085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC1084) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SD LPCMH2120) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2007-11-16 |