| NPI | 1306247440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 12211) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: RI MHC01210) |
| 225600000X Dance Therapist (Licence: R-DMT-2134) | |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2023-02-13 |