| NPI | 1699179960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180009682) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178008578) |
| 163W00000X Registered Nurse (Licence: IL 041163326) | |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2015-05-14 |