| NPI | 1477842516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2019-12-10 |