| NPI | 1356614747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 1815) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 1147) |
| 101YM0800X Counselor, Mental Health (Licence: NE 4496) | |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2019-12-10 |