| NPI | 1619010790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 3878-125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 59-136) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2009-09-18 |