| NPI | 1255375408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 3716) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: NC 1215) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2007-07-08 |