| NPI | 1235482621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 6572) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 10702) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2017-04-04 |