| NPI | 1659504652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD PLAN OF SUPERVISION) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE PMHP - 9585) |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2013-08-28 |