| NPI | 1720344658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C3628) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 65602) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2015-09-30 |