| NPI | 1629061015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 401) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 318) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2007-07-08 |