| NPI | 1710967161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 1276466004) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 6848) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2012-04-04 |