| NPI | 1720288723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 5289) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 6955) |
| 101YM0800X Counselor, Mental Health (Licence: GA LPC005720) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2011-07-20 |