| NPI | 1669507513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 40484) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 3170) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-07-08 |