| NPI | 1477871267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 1916-125) |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: WI 72287-30) |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: WI 72287-30) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2010-05-04 |