| NPI | 1518169606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OK 1391) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 12938) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2007-07-08 |