| NPI | 1366481152 |
|---|---|
| Former Name | JAIME RIDILLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA PC004047) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: PA PC004047) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2012-09-19 |