| NPI | 1396930301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH9573) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH4835) |
| 101YP2500X Counselor, Professional (Licence: NC 7218) | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2011-09-16 |