| NPI | 1396759502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 5377) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: RI 00194) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-07-08 |