| NPI | 1285061077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC6800) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP5278) |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2016-02-12 |