| NPI | 1235287723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH4863) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2013-09-24 |