| NPI | 1568791283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-6499) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043-068761) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2019-11-26 |