| NPI | 1225289150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 9338) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2015-09-02 |