| NPI | 1518247394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 7799) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional (Licence: VA 0701008164) | |
| 171W00000X Contractor | |
| 225800000X Recreation Therapist (Licence: NC 43287) | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2022-01-07 |