| NPI | 1699814426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 1812) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 203398) |
| 106H00000X Marriage & Family Therapist (Licence: MA 581) | |
| 163W00000X Registered Nurse (Licence: MA 169495) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2007-07-08 |