| NPI | 1285690206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: SC 2954) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: SC T822) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2007-07-08 |