| NPI | 1396133955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C3630) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 1679) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |