| NPI | 1568429553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2000152560) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 2000152560) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2019-03-20 |