| NPI | 1659752608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC6502) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC6502) |
| 101Y00000X Counselor (Licence: MD LC6502) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-11-20 |