| NPI | 1699011585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 40620) |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2019-01-17 |