| NPI | 1710038138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MA 173709) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MA 173709) |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2007-07-08 |