| NPI | 1518165554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 7455) |
| Additional Taxonomies | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: CO 91348) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2012-11-27 |