| NPI | 1275921074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL IMH577) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2020-02-20 |