| NPI | 1669545950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NM 0074581) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM 0090871) |
| 101YP2500X Counselor Professional (Licence: MS 1223) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2007-07-08 |