| NPI | 1205873957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 3476125) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WI 43493030) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2007-07-30 |