| NPI | 1417011578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT LCPC-750) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT 750) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2014-07-18 |