| NPI | 1386058436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A11091) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 119003) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2014-11-04 |