| NPI | 1639393036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 7443) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 216460) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH 8016) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2010-04-30 |