| NPI | 1255640421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C2659) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: 00097822) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2011-05-31 |