| NPI | 1649674748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 077708) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH C.1300496) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2015-12-14 |