| NPI | 1508083312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 1130) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 0553) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2014-06-16 |