| NPI | 1659749596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 001344) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: IA 00113598) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2018-03-17 |