| NPI | 1215090071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID 3313) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT 1171) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2016-01-15 |