| NPI | 1629293105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 1748) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 0018) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2007-07-08 |