| NPI | 1558632000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A17231) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 7505) |
| 235Z00000X Speech-Language Pathologist, (Licence: RI 00994) | |
| Enumeration Date | 2012-01-14 |
| Last Update Date | 2022-01-28 |