| NPI | 1710281837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 178002904) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 178.002904) |
| 101YS0200X Counselor School (Licence: IL 178.002904) | |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2011-10-18 |