| NPI | 1295876654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH4020) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 106401000664) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2007-07-08 |