| NPI | 1609274687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A14209) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2019-04-17 |