| NPI | 1720110174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM NMT0113881) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM 0094871) |
| 101YS0200X Counselor School | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-07-14 |