| NPI | 1558487736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701012740) |
| Additional Taxonomies | 225800000X Recreation Therapist |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2023-08-07 |