| NPI | 1255437372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0701003308) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701003308) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-07-09 |