| NPI | 1710071527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 7007) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME CC2544) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2011-07-01 |