| NPI | 1508130675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: UT 176162766) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2022-01-27 |