| NPI | 1639302813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 7696) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2013-04-26 |