| NPI | 1407926751 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH8730) | 
| Additional Taxonomies | 222Q00000X Developmental Therapist | 
| Enumeration Date | 2006-11-08 | 
| Last Update Date | 2012-04-13 |