| NPI | 1205108396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC7222) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPC-6314) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-10-01 |