| NPI | 1679610653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 103) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 2292) |
| 101YP2500X Counselor Professional (Licence: NE 1282) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2018-07-22 |