| NPI | 1518073139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 041-126573) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: IL 041-126573) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-08 |