| NPI | 1376955567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL ISW12099) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2021-01-24 |