| NPI | 1578810701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12778) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH10056) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2020-04-20 |