| NPI | 1710202908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA 12466) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA 12465) |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2013-04-18 |