| NPI | 1205214269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 081447) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 8867560-6009) |
| 101YM0800X Counselor, Mental Health (Licence: AZ LAC14470) | |
| 101YP2500X Counselor, Professional (Licence: CO 12366) | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2017-05-04 |