| NPI | 1285652057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: VA 0015000286) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 552) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2010-11-17 |