| NPI | 1518253897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14567) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH 8369) |
| 101Y00000X Counselor (Licence: FL IMH 8369) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2017-01-27 |