| NPI | 1215005798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 3453) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 3453) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2015-06-08 |