| NPI | 1376066746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4645) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AK 118969) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2018-04-30 |