| NPI | 1649567611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 5235) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2023-11-10 |