| NPI | 1700861077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NM 0822) |
| Additional Taxonomies | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: NM R14387) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2007-07-09 |