| NPI | 1609913664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C600034) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 5765) |
| 101YM0800X Counselor, Mental Health (Licence: 85224) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |