| NPI | 1689894446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 11745) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH C0500347) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2015-08-10 |