| NPI | 1639115967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.011997) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH00008164) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2019-01-22 |