| NPI | 1265453732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701004204) |
| Additional Taxonomies | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: VA 0001110378) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2008-12-28 |