| NPI | 1295964609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist (Licence: FL 0-12-5005) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH11252) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2013-02-11 |