| NPI | 1639130289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IN 260-426-7234) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39000113A) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2007-07-08 |