| NPI | 1548738073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: PA 2478527) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: PA 2478527) |
| 101YS0200X Counselor School (Licence: NJ 2478527) | |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2018-11-02 |