| NPI | 1629067004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 2000) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 7654) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2011-01-24 |